John Kelly Theisen, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

106339 Issued in CO

Practice address

521 E Railroad Ave
Fort Morgan, CO 80701-3331

Phone

(970) 867-2256

Fax

(970) 542-9464

NPI assigned

Jul 11, 2005

Sex

Male

Sole proprietor

No

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• J. Kelly Theisen, D.D.S.

  • Dentist
  • Fort Morgan, CO
  • NPI 1871979393
  NPD (past) Authorized official

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 13, 2026.

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1629076989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 E RAILROAD AVE",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807013331",
            "telephone_number": "970-867-2256",
            "fax_number": "970-542-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 E RAILROAD AVE",
            "city": "FORT MORGAN",
            "state": "CO",
            "postal_code": "807013331",
            "telephone_number": "970-867-2256",
            "fax_number": "970-542-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THEISEN",
        "first_name": "JOHN",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "106339",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• All providers in Fort Morgan, CO
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.